I can’t sleep: Is it insomnia, sleep apnea or both?

It’s not unusual to have a few nights here and there where you don’t sleep through or as well as
you’re used to. That doesn’t mean you have a sleep problem. However if your sleep is continually
disrupted because you struggle to fall asleep, stay asleep or wake up too early consistently for more
than three times a week for three months, then you could have a sleep problem. Approximately 10 –
40% of the general population suffers from a sleep disorder.

What is insomnia?

Insomnia is the most common sleep disorder. It is estimated that 15% of all adults suffer from
insomnia and between 10% and 30% of adults struggle with chronic insomnia. Women have a
lifetime risk of developing insomnia which is 40% higher than men.

Insomnia is usually diagnosed by self-reported symptoms although there are standard
questionnaires which can be used to determine the level of insomnia. It’s not unusual for a person’s
self-reported sleep experience to be at odds with a sleep study, which is measured objectively in a
sleep laboratory environment.

You will be diagnosed with insomnia if you meet the criteria for insomnia. This means you
experience difficulty falling asleep, staying asleep or waking too early even when you have given
yourself enough time to sleep and you have felt tired and wanted to sleep. In addition to this, you
feel tired and unable to function at your best during the day.

What is the link between insomnia and mental health?

There is a bi-directional relationship between insomnia and mental health. You can develop a mental
health condition as a result of insomnia. Or you can develop insomnia as a result of a mental health
condition. Often symptoms of being under-slept can be mistaken for depression. However
approximately 75% of adults with depression suffer from insomnia and more than 90% of people
who experience PTSD as a result of military combat, suffer from insomnia.

The effects of insomnia

If you suffer from insomnia, you have no doubt made adjustments so that you can adapt and
manage the side effects better. The short-term side effects of insomnia are more than just the loss
of quality and quantity of sleep. It includes impaired concentration and focus, loss of creativity,
pattern recognition and developing insight, difficulty making decisions, learn and commit items to
memory, emotional regulation, recognising social cues and developing trusted relationships.

The medium-term effects include weight gain, depressed immunity, slower brain functioning and
respiratory issues.

The long-term effects of insomnia, which are often only realised in later years include
cardiovascular issues, diabetes, musculoskeletal issues, some cancers, injuries and mental health
conditions.

If I have insomnia, will I also have sleep apnea?
Not necessarily is the short answer however it is possible that you could have both.

What is sleep apnea?

Sleep apnea occurs when the sleeper involuntarily stops breathing during sleep. It is often
characterised by loud snoring, and it is measured by the frequency of apnoeic events and the length
of the apnoeic event.

Obstructive sleep apnea (OSA) is becoming more common although many people with ISA go
undiagnosed and untreated. Statistics show that it affects 9% of women and 26% of men between
the ages of 30 and 49 years of age. That increases between 50 and 70 years of age, with 27% of
women and 43% of men.

What are the symptoms of sleep apnea?

People with OSA experience frequent episodes of shallow breathing and pauses in breathing for 10
seconds or more. Often sleep partners comment on the pauses in breathing because often the
person with OSA doesn’t notice.

Other symptoms of OSA may include; daytime tiredness; limited ability to concentrate; sudden
awakenings; sometimes with a racing heart or a feeling of breathlessness; dry mouth on wakening
due to snoring; night sweats and a frequent need to urinate. In men, it could also be responsible
for impotence and erectile dysfunction.

The long-term effects of OSA
The long-term effects of sleep apnea are worth taking note of.
50% of people who have atrial defibrillation also have sleep apnea.

If you have been diagnosed with sleep apnea you are more likely to have:

• arrhythmia (abnormal heart rhythm) that can lead to a stroke.
• diabetes and cardiovascular disease.
• dementia
• anxiety or depression
• fibromyalgia, which is a chronic pain condition

So, what do I have?

As you can see there is an overlap between insomnia and OSA and sometimes people can incorrectly
self-diagnose insomnia when it is really OSA, that is why it is always a good idea to have a test to rule
out OSA before engaging in insomnia treatment. Although insomnia treatment (CBT-i) has been
proven to be effective in managing OSA more effectively.

How can I get tested?

If you suspect you could have insomnia and it hasn’t been improving, then I encourage you to seek
out support so you can get your sleep back on track and avoid those long-term effects. There is no
need to suffer from insomnia. A scientifically proven treatment, which I am trained in, is Cognitive
Behavioural Therapy for Insomnia (CBT-i) which is more effective in the long run than taking sleeping
tablets or supplements.

OSA can now be diagnosed with an at-home sleep test. You do not need to a referral or to go into a
sleep lab. The at-home studies are easy to use and less disruptive than the polysomnography that is
attached to you in a sleep lab.

Only a sleep physician can diagnose you with OSA through a diagnostic test like the ones done in the
lab or the at-home tests. The solutions for sleep apnea vary depending on your OSA severity.

We offer clients at-home sleep tests, which you can administer yourself. Your sleep results will be
saved to the cloud and a sleep physician will review your results and can provide a diagnosis and
next steps.

If you are interested in exploring your sleep problem, then book in a confidential call where we can
discuss your specific symptoms and possible solutions.